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Ferenc B. Sallo, Tunde Peto, Catherine Egan, Ute E. K. Wolf-Schnurrbusch, Traci E. Clemons, Mark C. Gillies, Daniel Pauleikhoff, Gary S. Rubin, Emily Y. Chew, Alan C. Bird, the MacTel Study Group10; “En face” OCT Imaging of the IS/OS Junction Line in Type 2 Idiopathic Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2012;53(10):6145-6152. doi: 10.1167/iovs.12-10580.
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We investigated abnormalities of the photoreceptor inner/outer segment (IS/OS) junction layer viewed “en face” and their functional correlates in type 2 idiopathic macular telangiectasia (type 2 MacTel).
Segmentation and “en face” imaging of the IS/OS lines in spectral domain optical coherence tomographic (SD-OCT) volumes were performed manually. Mesopic retinal sensitivity thresholds were determined using a Nidek MP1 microperimeter. “En face” SD-OCT images and microperimetric data were superimposed over images of the fundus. Retinal structure and characteristics of type 2 MacTel were analyzed, and associations of structural changes with function were investigated.
We examined 49 eyes of 28 patients (mean age 62.6 ± 9.4 years). Total IS/OS break area ranged from 0.04 to 2.23 mm2 (mean 0.63 mm2, SD 0.53 mm2) and 0.03 to 1.49 mm2 (mean 0.49 mm2, SD 0.42 mm2) in right and left eyes, respectively. A correlation between fellow eyes was present (Spearman correlation ρ = 0.770, P < 0.01). An assessment of the repeatability of IS/OS lesion area measurements (n = 19 eyes) revealed an intra-class correlation coefficient of 0.99 (95% confidence interval [CI] of 0.975–0.996). Retinal areas corresponding to an IS/OS break showed a mean retinal sensitivity of 8.3 ± 5.8 and 8.7 ± 5.7 decibels (dB) in right and left eyes, respectively. Mean sensitivity over retinal areas outside the lesion was significantly higher, 17.0 ± 3.3 and 16.7 ± 3.6 dB in right and left eyes, respectively (paired t-test, P < 0.01). Mean aggregate retinal sensitivity loss was 33.5 ± 30.4 dB (n = 40), correlating well with IS/OS lesion area (Pearson correlation coefficient = 0.848, P < 0.01).
“En face” OCT imaging of the IS/OS junction layer provides a functionally relevant method for assessing disease severity in type 2 MacTel.
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